Cosmetic Surgery

Functional Upper Lid Blepharoplasty

Blepharoplasty is the scientific name for eyelid surgery, but there are different types of Blepharoplasty. Functional (medically necessary) Upper Lid Blepharoplasty is a procedure that removes excess skin from the upper lids that limits your peripheral vision and prevents you from seeing properly. Because vision is affected, health insurance usually covers the surgery.

If you have droopy upper eyelids that are not impairing your vision enough for insurance coverage, you may opt for Cosmetic Upper Eyelid Blepharoplasty, performed for cosmetic reasons. In that case, insurance does not cover the procedure.

If your upper eyelids inhibit your ability to see well, you may be eligible for fully covered Functional Upper Lid Blepharoplasty in St. Louis.  However, insurance companies require that the vision is impaired to a specific degree before they will cover the cost of the surgery.

Your Consultation

 

When you arrive, you will need to provide a medical history, as we need to know about major illnesses and problems such as heart disease and hypertension. Prior surgery, especially facial surgery, is important. Medication history, including medications or supplements that thin the blood are vital to disclose. All over-the-counter pain/fever reducers (except Tylenol) and non-steroidal anti-inflammatory drugs (NSAID) are off limits for a week before eyelid surgery. Herbal medications such as ginkgo biloba and St. John’s Wort or high doses of fish oil, flax seed oil, or vitamin E must also be avoided.

Dr. Holds will ask you about what aspect of your eyelids bothers you and will discuss how this may relate to aging changes in nearby parts of your face. Eyebrow position is particularly important in relation to upper eyelid surgery.

For upper blepharoplasty to be covered by insurance as a medically necessary condition, we must document a visual complaint consistent with the drooping upper lids that affects your activities of daily living. We will discuss exactly what your surgical goals are, what is attainable, and will create a plan to accomplish that. A mutual understanding of the goals, expectations, and outcomes is essential to a great result!

During your consultation, an examination is also performed to look at any eye conditions such as dry eye, which could limit or alter the surgical plan or be a concern after your procedure. For insurance coverage, we must also have photographs and visual field tests (peripheral vision) that verify your difficulties in seeing as a result of the drooping eyelid.

As a board-certified ophthalmologist (eye surgeon), as well as an ophthalmic plastic surgeon, Dr. Holds is attuned to eye diseases and concerns. He is routinely referred patients by some of the best facial and cosmetic surgeons in the area because of this expertise and ability to safely operate on patients at higher risk for complications.

What is Functional Upper Lid Blepharoplasty Like?

You can have the procedure as an outpatient under local anesthesia and perhaps a sedative. Since you will still feel sleepy after your surgery, someone else must drive you home.

The incision is made in the crease of your upper eyelid so that the small scar is hidden. Excess skin is then removed to improve peripheral vision. Of course, Dr. Holds or his associates are careful to make sure that both of your eyes will match as closely as possible after surgery.

We often perform an additional procedure such as a Brow Lift at the time of upper blepharoplasty surgery. Patients also sometimes decide to optimize their cosmetic result with additional cosmetic sculpting of the eyelid fat pads.

 

Recovery from Functional Upper Lid Blepharoplasty

Sutures are removed in the office 6-8 days after surgery, although dissolving sutures are used in some situations. Some bruising, swelling, and soreness may develop after the anesthetic wears off. You can take pain medication, if necessary, and you will be asked to sleep with your head elevated and apply ice packs to your eyes periodically to keep the swelling down. You may also be given orders for eye drops or ointments to put in your eyes for one to two weeks.

The bruising usually lasts no more than two weeks, but sometimes, it can last a bit longer. You should be able to return to work after a week to ten days, at which time you can cover any remaining bruises with makeup.

 

If your vision has been impaired by drooping upper eyelids, call our office now at (314) 567-3567 to find out if you’re a good candidate for Functional Upper Lid Blepharoplasty.